News from The 2014 American Thoracic Society Conference

The American Thoracic Society held its International Conference from May 16-21 in San Diego, California, and was attended by approximately 15,000 professionals including pulmonary doctors and nurses, book publishers, and employees of pharmaceutical companies interested in lung diseases.

Several sessions at the conference focused on preventing COPD exacerbations. An exacerbation means an increase in coughing, more phlegm which may be yellow or green, and/or more shortness of breath usually due to a chest infection.

As part of the Affordable Care Act, hospitals will not be paid if you are readmitted to the hospital within 30 days after being discharged with a diagnosis of a COPD exacerbation. This rule starts in October 2014. One of the speakers, Gerald Criner, M.D. of Temple University School of Medicine in Philadelphia, emphasized that a follow-up appointment with your primary care or pulmonary doctor was important in preventing the need for re-hospitalization. An appointment about 2 weeks after discharge makes good medical sense as it enables your doctor to check on how you are doing and make sure that you are taking the best medications for your COPD. Your doctor can also check your oxygen level as some individuals improve enough that oxygen can be stopped if it was prescribed at the time of discharge.

It is IMPORTANT that you and family members make sure that you have a follow-up scheduled about 2 weeks after being discharged from the hospital. At that appointment, make sure to ask your primary care or pulmonary doctor about different medications that have been approved by the Food and Drug Administration to reduce the risk of having another COPD exacerbation. These include inhaled medications:

  • tiotropium (Brand name: Spiriva™ HandiHaler™)
  • fluticasone propionate and salmeterol combination (brand name: Advair™)
  • fluticasone furoate and vilanterol (brand name: Breo™ Ellipta™)
  • Your doctor may also consider prescribing roflumilast (brand name: Daliresp™), a pill taken once daily, that reduces the risk of an exacerbation, but only if you cough up phlegm most day (chronic bronchitis), have severe COPD, and have a history of frequent exacerbations.